National Association of Chain Drug Stores, Aug. 25-27

The Total Store Expo of the National Association of Chain Drug Stores (NACDS) was held from Aug. 25 to 27 in Denver and attracted approximately 5,000 participants from around the world, including individuals associated with national and regional traditional drug stores, supermarkets, and mass merchants, as well as drug store chain suppliers. The conference highlighted the latest innovations in consumer packaged goods, store/pharmacy technology, pharmaceutical products entering the market, and the most up to date information on state-of-the-art pharmacy operations, practice and clinical issues, and distribution and marketing.

Remarks from NACDS President and CEO Steven C. Anderson, during the Expo's opening session, focused on issues that retail drug store chains may face, including the tariffs being imposed by our nation and potential retaliation by our trading partners.

"This trade dispute has already involved tariffs on billions of dollars of goods, and has targeted hundreds of billions of dollars more. The emerging trade war is on the minds of those doing business here at the Total Store Expo, and on the minds of consumers. Diverse products, packaging, and equipment already are being affected. And more items are being added to the tariff list. There are increased freight costs, too," Anderson said during the session. "This matters to the entire supply chain. Think about it. It affects the products on store shelves. It affects the process of getting those products to the shelves. And it even affects the shelves themselves, given rising steel costs."

A survey that the NACDS had conducted by Morning Consult, a polling and media company, focused on the city of Denver and found that 65 percent of residents were concerned about retaliatory tariffs imposed on the United States by other countries, while only 23 percent said they were not worried. In addition, most were concerned about price increases, especially for health care products, and job losses.

Also during the opening session, NACDS Chairman of the Board Mark Panzer, Senior Vice President of Pharmacy Health & Wellness at Albertsons Companies, discussed direct and indirect remuneration (DIR) fees, preserving patient access through appropriate pharmacy reimbursement, expanding pharmacy's scope of practice, and serving as part of the solution on the opioid abuse epidemic. He also focused on progress on the "Access Agenda," which involves playing aggressive offense and tough defense on pressing issues, while serving as a working partner for stronger and safer communities.

"The fact is that there are barriers. And we need to continue to aggressively address them. And there also are many opportunities for us to do more for patients. We need to continue to focus on those opportunities," Panzer said. "NACDS talks about this in terms of our Access Agenda. It really does come down to the three parts of the Access Agenda: offense, defense, and addressing issues that matter to the well-being of our communities."

On the offense, Panzer discussed enhancing access to newer services, including pushing for pharmacists to be able to do more and supporting and pushing to expand pharmacists' scope of practice, whether it's new and enhanced screenings, pharmacogenetics, or administering specific prescribed injections or new vaccines. On the defense, Panzer talked about preserving patients' access to care and DIR fees.

"Basically, the way things have come to work, a pharmacy can be reimbursed for a prescription, only to find out later that a portion of that reimbursement is being clawed back by a payer. This is not a sustainable business model. So, reforming DIR fees is a top priority for the industry and NACDS," Panzer said. "On our Access Agenda, those are examples of offense and defense. The third area -- serving as working partners for stronger and safer communities -- includes being part of the solution to the opioid abuse epidemic."

A strong focus of the Expo was addressing the opioid abuse epidemic. The NACDS recommendations on opioid drug prescribing, which Panzer also discussed during the opening session, include limits on initial opioid prescriptions for acute pain, mandatory electronic prescribing, a nationwide approach to leverage technology to help keep opioids out of the wrong hands, and new disposal solutions.

"Take electronic prescribing, which helps stop fraud and abuse. It was not that long ago that NACDS was on the leading edge of urging the Drug Enforcement Administration to allow electronic prescribing of controlled substances. Now, it's not just about allowing it, which took effect in 2010. Now, we're working to mandate it. We have moved from a question of 'may' to a question of 'mandatory,'" Panzer said during the opening session. "On drug disposal, legislation enacted in Washington State earlier this year now is being shown by NACDS as a model for other states. It has many of the essential qualities for the public good. It's flexible enough to be responsive to local needs, yet it creates a statewide program rather than a patchwork quilt of community-by-community approaches."